You are doing a history assessment on a new patient that was just transferred to your unit. As you ask her questions she eludes that she is living with family who are supposed to be caring for her but they are taking her retirement checks and only giving her very little of it. What type of abuse would you consider?

Choice A reason: Painful urination, or dysuria, involves discomfort during voiding, often due to urinary tract infections or inflammation. It is not synonymous with nocturia, which specifically refers to frequent nighttime urination. Dysuria requires distinct clinical evaluation, including urinalysis, to identify causes like bacterial infection or urethral irritation, making this an incorrect description of the patient’s complaint.

Choice B reason: Nocturia is the medical term for frequent urination at night, disrupting sleep. In elderly patients, it may result from reduced bladder capacity, overactive bladder, or conditions like benign prostatic hyperplasia. This matches the patient’s complaint, as it directly addresses the symptom without implying unrelated issues like pain or incontinence, making it the accurate choice.

Choice C reason: Bladder incontinence involves involuntary urine leakage, distinct from nocturia, which is voluntary urination at night. Incontinence may stem from neurological disorders or weakened pelvic muscles but does not describe the patient’s symptom of frequent nighttime voiding. This choice is incorrect, as it misaligns with the clinical presentation described.

Choice D reason: An inability to void, or urinary retention, is the opposite of nocturia, where the patient voids frequently. Retention may result from obstructions like an enlarged prostate or neurological issues, requiring catheterization or imaging for diagnosis. This choice does not reflect the patient’s symptom of active, frequent urination at night.

Choice A reason: Burning urination, cloudy urine, and urethral pain are classic UTI symptoms, caused by bacterial infection (e.g., Escherichia coli) irritating the urinary tract. Prompt recognition guides antibiotic therapy and hydration, preventing complications like pyelonephritis. Accurate diagnosis ensures timely treatment, critical for relieving discomfort and avoiding infection spread in affected patients.

Choice B reason: Kidney obstruction typically causes flank pain, reduced urine output, or hematuria, not burning urination or cloudy urine. These symptoms align with UTI, not obstruction. Misidentifying risks delaying UTI treatment, potentially leading to kidney damage or sepsis, while unnecessary imaging for obstruction complicates care unnecessarily.

Choice C reason: Stroke presents with neurological symptoms like weakness or confusion, not urinary symptoms like burning or cloudy urine. These indicate UTI, not stroke. Assuming stroke misdirects care, delaying antibiotic treatment for UTI, risking infection progression and overlooking neurological assessment needed for actual stroke symptoms.

Choice D reason: Heart failure causes edema, dyspnea, or fatigue, not urinary symptoms like burning or cloudy urine, which suggest UTI. Misidentifying as heart failure risks neglecting antibiotic therapy, allowing UTI to worsen, potentially causing sepsis. This error diverts focus from cardiac assessment needed for heart failure management.